Combining Asset Accumulation and Multifamily Group Intervention to Improve Mental Health for Adolescent Girls: A Cluster-Randomized Trial in Uganda.
Combining Asset Accumulation and Multifamily Group Intervention to Improve Mental Health for Adolescent Girls: A Cluster-Randomized Trial in Uganda.
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结合资产积累和多家庭群体干预改善青春期女孩的心理健康：乌干达的整群随机试验。
DOI：
10.1016/j.jadohealth.2023.08.012
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Dvalishvili,Darejan
中科院分区：
文献类型：
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作者：
Karimli,Leyla;Nabunya,Proscovia;Ssewamala,FredM;Dvalishvili,Darejan
本研究的目的是扩大对乌干达南部受贫困和艾滋病毒/艾滋病影响的家庭中青春期女孩的贫困、家庭功能和心理健康之间关系的现有知识。本研究调查了家庭功能与心理健康之间的关系，并检验了家庭功能是否调节了青少年心理健康的干预效果。方法采用整群随机对照试验，在乌干达进行了为期24个月的纵向数据收集，对象为N=1260名14-17岁女孩。研究对象随机分为对照组(n=16所学校408名女生)、青少年发展账户配对治疗组(n=16所学校471名女生)、综合干预组(n=15所学校381名女生)。调节因素分析表明，家庭亲密度(χ2(4)=21.43；p=.000)、家庭沟通频率(χ2(4)=9.65；p=.047)和儿童与照顾者关系的质量(χ2(4)=11.12；p=.025)显著抑制了干预对贝克绝望感的影响。此外，对抑郁的干预效果被家庭交流的舒适性所缓和(χ2(4)=10.2；p=0.037)。讨论本研究结果强调了家庭功能在考察贫困与青少年心理健康之间的联系时的重要性。这项研究提供了稀缺的证据，表明资产积累机会与加强家庭的组成部分相结合，可能会改善贫困家庭的育儿做法和青少年的心理健康。
PurposeThe aim of this study is to expand the current knowledge on the relationship between poverty, family functioning, and the mental health of adolescent girls in families affected by poverty and HIV/AIDS in southern Uganda. The study investigates the association between family functioning and mental health and examines whether family functioning moderates the intervention effect on adolescent mental health.MethodsLongitudinal data were collected over the course of 24 months in a cluster randomized controlled trial conducted among N=1,260 girls aged 14–17 years in Uganda. Participants were randomized into control group (n=408 girls from n=16 schools), matched youth development accounts treatment, YDA (n=471 girls from n=16 schools), and integrated intervention combining YDA with multiple family group component (n=381 girls from n=15 schools).ResultsWe found a significant positive association between family functioning and mental health of adolescent girls in our sample. Moderator analyses suggests that effect of the intervention on Beck Hopelessness Scale was significantly moderated by family cohesion (χ2(4) =21.43;p= .000), frequency of family communication (χ2(4) =9.65;p= .047), and quality of child-caregiver relationship (χ2(4) =11.12;p= .025). Additionally, the intervention effect on depression was moderated by the comfort of family communication (χ2(4) =10.2;p= .037).DiscussionThe study findings highlight the importance of family functioning when examining the link from poverty to adolescent mental health. The study contributes to the scarce evidence suggesting that asset-accumulation opportunities combined with a family strengthening component may improve parenting practices and adolescent mental health in poor households.